To review the diagnosis and treatment of depressive disorders in long-term care settings.A review of the literature on the diagnosis and treatment of depression in long-term care.Up to 35% of residents in long-term care facilities may experience either major depression or clinically significant depressive symptoms. These symptoms are often not recognized for at least 2 reasons: depression is not the focus of physicians and nursing personnel and depression is frequently comorbid with other problems that are common in long-term care, such as cognitive impairment, medical illness, and functional impairment. Nevertheless, depression, once diagnosed, can be treated effectively in the nursing home setting. The foundation of treatment is pharmacotherapy, yet other therapeutic approaches, such as exercise and psychological therapies may be of value.Depression, although often unrecognized in long-term care, is a treatable condition and deserves the attention of the entire medical and nursing staff.